Objectives To test a simple method for genotyping of C.trachomatis isolates and to investigate the clinical significance of the genotypes. Methods A part of the chlamydial genome encoding the major outer membrane protein(omp1) was amplified by polymerase chain reaction (PCR). The products were digested by endonucleases to see the characteristic patterns, after silver staining on 10% polyacrylamide gels. Results The omp1 genes of 15 serovars of C. trachomatis were amplified by PCR,which generated an 871 base pair gene fragment. AluⅠ digestion of the product gave characteristic patterns for the 15 serovars,but group C presented closely similar patterns. A triple digestion with HpaⅡ, followed by HinfⅠ and EcoRⅠ, would allow the differentiation of serovars in group C. Analysis of 74 clinical isolates revealed serovars E, F, D, G as the most prevalent genital serovars in the studied populations. Serovars B, H, J were occasionally identified. A mixed infection with serovars F and D was seen in a clinical sample. No significant relationship was observed between clinical manifestations of urogenital chlamydial infections and serovars,however,serovar D was more often associated with high titer of anti chlamydial antibody than other serovars. Conclusion The omp1 genotyping technique seems to be promising for epidemiological studies.

Hospital TQM system is designed to fit China′s specifics,based on the Total Quality Management (TQM)theory and integrating the system theory concepts, comprising two structural modules of perceived quality and non-perceived quality.The former is a trinity framework made up of patient satisfaction,employee commitment and social reputation,while the latter is a management system featuring“Six pillars and six columns”,constituting a three-dimensional management for integrated operation and integration of the hospital.

Fifteen min after adding nimodipine 50 ?mol/L, the contractility of the left atrial muscle decreased from 100 % of control to 55.5 +4.2 o/o and its inhibitory effect was equal to the effect of verapamil (25 ?mol/L ) . Nim at the same concentration inhibited strongly the positive staircase phenomenon but could not reverse it into the negative staircase phenomenon as verapamil 25 ?mol/L did. The same concentration of Nim suppressed significantly the post rest contraction. On the contrary, the post rest contraction was not affected by verapamil at 25 ?mol/L. In addition, Nim 50 ?mol/L reversed or prevented significantly the ouabain-induced arrhythmias in isolated left atria. These results suggest that the negative ino-trbpism of Nim may be related not only to the inhibition of Ca2 + influx to the cells and also to the decrease of the intercellular Ca2+ release and that Nim might present the possibility in treating arrhythmias or other heart disease

Hepatocelular carcinoma ( HCC) is one of the most common causes of cancer death worldwide. Although surgical resection offers a better curative option than nonsurgical treatments, it is not an option for the majority of patients with poor hepatic function or at an advanced stage when diagnosed.Transcatheter arterial chemoembolization (TACE) is an alternative and effective nonsurgical treatment for HCC. Evaluation of the effect of TACE is important to develop a best therapeutic strategy. From January 2009 to December 2010, 28 patients with HCC received TACE at the PLA General Hospital, and the results of magnetic resonance imaging ( MRI) were analyzed. Fifty-one lesions were detected and the maximum diameter of the lesions was 14.7 cm. Twenty-eight lesions in 16 patients which showed variable signal intensity on T1- and T2 -weighted images and iso- or hypointensity on diffusion-weighted image ( DWI) had no enhancement. Five lesions of 10 tumors in four patients had focal enhancement in the first MRI after TACE that displayed hyperintensity on DWI. Eight patients had been found with tumor recurrence or metastasis when they received MRI for the second time. The recurrent, residual and intrahepatic metastatic tumors enhanced rapidly at dynamic early phase scanning and demonstrated hyperintensity on T2 -weighted images.

Catharanthus roseus (L.) G. Don is a plant of the Catharanthus genus of Apocynaceae which has been reported to have therapeutic effects of detoxication and anticancer. In order to further study the alkaloid constituents of C. roseus, the aerial parts of the plant were extracted with 95% EtOH, and then treated with 2% H2SO4 and NH3H2O to obtain total alkaloids. The total alkaloids were separated and purified by column chromatography over silica gel and prepared by high performance liquid chromatography (HPLC). Their structures were elucidated on the basis of physicochemical properties and spectral data. A new alkaloid together with five known compounds were isolated and identified as vindolinine B (1), lochnericine (2), horhammericine (3), vindorosine (4), vindoline (5), and coronaridine (6). Compound 1 is a new compound and named as vindolinine B.

Objective To document the MRI features of renal angiomyolipoma (RAML) containing minimal fat and to explore whether the MR features vary depending on the tumor size. Methods The MR findings of 15 cases of pathologically-proved RAML containing minimal fat were reviewed retrospectively from January 2008 to March 2010. All patients underwent MR in a 1.5 T or 3.0 T scanners. The MR features of the lesions were analyzed, with emphasis on the signal intensity and homogeneity on T2WI, in regards to pseudocapsule, lipid component, hemorrhage, cystic degeneration or necrosis, blood vessels, interface with renal parenchyma and enhancement pattern. All lesions were categorized into 2 groups; those with diameter ＞4 cm and those with diameter ≤4 cm. The difference of imaging characteristics between these two groups was analyzed using Fisher exact test. Results All 15 lesions demonstrated hypointensity on T2WI compared to the renal parenchyma. Homogeneous signal intensity on T2WI was seen in 6 lesions (6/15); peritumoral pseudocapsule in 3 lesions (3/15); cystic degeneration or necrosis, hemorrhage in 5 lesions (5/15); flow void of blood vessels in 2 lesions (2/15); lipid component in 4 lesions (4/15); angular interface with renal parenchyma in 10 lesions (10/15); homogeneous enhancement in 8 lesions (8/15). Fifteen lesions were divided into two groups; 9 categorized into group 1 (the maximum diameter ≤ 4 cm) and 6 into group 2 ( the maximum diameter ＞ 4 cm). Cystic degeneration or necrosis was seen in 0 of 9 in group one and 5 of 6 in group two respectively, hemorrhage(0 of 9 and 5 of 6 respectively) and pseudocapsule(0 of 9 and 3 of 6 respectively. The difference between these findings in the two groups demonstrated statistical significance (P ＜ 0. 05). Conclusion The MR features of RAML containing miminal fat were hypointensity on T2 WI,angular interface with renal parenchyma and homogeneous contrast enhancement, however, these findings can vary depending on the tumor size.

BACKGROUND: The osteoarthritis (OA) is attributed to Gubi of TCM,which is mainly caused by liver and kidney deficiency, deficiency and damage of both qi and blood and wind-cold-damp pathogen. Kidney-deficiency with coagulating-coldness syndrome is very common.OBJECTIVE: To explore the clinical effect of the treatment of OA by invigorating the kidney, dispelling the cold and activating collaterals.DESIGN: Randomized controlled clinical study.SETTING: Department of Traditional Chinese Medicine, Dongguan Shilong People's Hospital of Guangdong Province.PARTICIPANTS: Eighty-eight inpatients and outpatients who were most possible to benefit from the experiment were selected as the subjects from the Department of Rheumatism and the Clinic of Orthopedics from June 2005 to July 2006. All subjects were randomized into the experimental group (n=44) including 21 males and 23 females, whose ages ranged 42-70 years, and their average age was (62±8) years and the average course of diseases was (34±18) months, and the control group (n=44), including 24 males and 20 females, whose ages ranged 40-69 years, and their average age was (61±7) years and the average course of diseases was (34±16)months.METHODS: Patients in the experimental group were treated with Bushen Quhan Tongluo herbs by orally taken or externally washing. The prescription of Bushen Quhan Tongluo: Hutaorou (12 g), Buguzhi (12 g), Chaoduzhong (12 g), Shudi (15 g), Dahuixiang (9 g), Luoshiteng (15 g),Zhichuanwu (9 g), Sanqi (6 g), Wugong (3 g), Jixieteng (15 g). The prescription for external washing: Tuogucao (40 g), Danggui (15 g), Sumu (15 g),Shengdahuang (15 g), Shengnanxing (10 g), Ruxiang (10 g), Meyao (10 g),Bingpian (3 g). (Orally taken: The medicine shall be taken with water of 37 ℃ one dose a day. External washing: The medicine that dissolved in 500 mL of 100 ℃ boiled water was adopted to wash both knees while the temperature down to 35 ℃ one dose upon a time and twice a day). Patients in the control group were given sulfated glucosamine (Weiguli Capsule.Each capsule contains 314 mg of sulfated glucosamine crystal, which is equal to 250 mg of sulfated glucosamine) two capsules a time and 3 times a day as well as piroxicam (Yantong Xikang Pill) once a day and 20 mg each time. Patients in both groups were administrated for 12 weeks. Referring to the Western Ontario and McMaster Universities (WOMAC) OA index and the clinical effect criterion of OA, the curative effect was compared between the two groups.MAIN OUTCOME MEASURES: WOMAC pain score, stiffness score,physiological function score, total score and the clinical effect.RESULTS: A total of 88 patients were involved in the analysis of results.joint stiffness index, physiological function index and the total index after the treatment in both the experimental group and the control group than those before the treatment (The experimental group: 4.95±2.46,11.39±4. 10;0.70±0.88,1.57± 1.42; 13.16±5.71,31.16± 10.08; 18.82±7.96,44.11 ± 13.29;Control group: 6.64±1.81,11.59±3.07 ;0.68±0.86,1.52±1.34; 14.25±3.99,pain index in the experimental group after the treatment was lower than that in thecontrol group, and the difference was remarkable (P ＜ 0.05),The total effective rate was 95.5% in the control group and it was 93.2% in the experimental group, and there was no marked difference between the epigastric discomfort in the control group, while there was no haematemesis, hemafecia or aggregation due to continuous administration. No adverse effect was found in the experimental group.CONCLUSION: Satisfying effect can be achieved in the treatment of OA of cold coagulation due to kidney deficiency by invigorating the kidney,dispelling the cold and activating the collaterals, moreover, the effect of relieving pain is especially excellent.

Objective To explore the change of Doppler velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia and to assess its value in fetal lung maturity.Methods A prospective study was conducted to analyze fetal main pulmonary artery velocity waveforms parameters including acceleration time(AT),ejection time(ET),acceleration time/ejection time (AT/ET),peak systolic velocity (PSV) in 30 cases of pregnant women with early onset severe preeclampsia.According to neonatal outcome,these cases were divided into respiratory distress syndrome (RDS) group (18 cases) and non-RDS group (12 cases).Each group was compared with 54 cases and 36 cases that were normal and had corresponding gestational age separately.Doppler parameters were compared between these two groups and their corresponding normal control groups.Results Gestational age at sonographic examination,gestational age at delivery and birth weight of neonates in RDS group were significantly lower than those in non-RDS group(all P ＜0.001).The value of AT,ET,AT/ET,PSV were lower in RDS group than those in gestational age-matched control group(all P ＜0.05),while there were no significant difference between non-RDS group and gestational age-matched control group(all P ＞ 0.05).Conclusions Doppler ultrasound monitoring fetal main pulmonary artery velocity waveforms to evaluate fetal lung maturity in patients with early onset severe preeclampsia has clinical application value.

Objective To study the influence of breast-feeding on the common neonatal comorbidities of very low birth weight (ELBW) infants.Method A retrospective study was conducted in our hospital from July 2014 to September 2015.The ELBW infants with birth weight between 1 000 g and 1 500 g were enrolled into the study.The infants were assigned into three groups according to human milk intake during hospitalization:high-volume breast feeding group (the high-volume group) (human milk equal to or greater than 75％),small-volume breast feeding group (the small-volume group) (human milk less than 75％) and premature formula group (the formula group) (exclusive formula fed during hospitalization).The general status,weight gain,the incidences of gastrointestinal dysfunction,neonatal necrotizing enterocolitis (NEC),late onset sepsis,premature retinopathy (ROP),bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) during hospitalization were compared between the three groups.Logistic regression analysis was applied.Result A total of 210 cases were included in the study.32 cases in the high-volume group,73 cases in the small-volume group and 105 in the formula group.The incidence of NEC (Bell's stage Ⅱ and Ⅲ) in the high-volume group was significantly lower than the small-volume group and the formula group (6.3％ vs.24.7％,26.7％) (P ＜ 0.05).No statistical differences existed as for the incidences of gastrointestinal dysfunction,sepsis,ROP,BPD,and PVL (P ＞0.05).Logistic regression analysis showed that the odds ratio (OR) of survival without NEC in the highvolume group were 0.183 compared with the formula group and 0.204 compared with the small-volume group;and the 95％ confidence interval were 0.041 ～0.818,0.044 ～ 0.938 respectively.No statistically significant differences existed among the three groups in the growth rate of body weight,the time needed to regain birth weight,the time needed to reach total enteral nutrition and the length of hospital stay (P ＞0.05).Conclusion High-volume breast milk intake can reduce the incidence of NEC (Bell's stage Ⅱ and Ⅲ).Breast-feeding has little adverse effects on common comorbidities of ELBW infants.Enhanced breastfeeding has similar efficacy comparing with formula feeding in the catch-up growth.

Chinese donation after citizen's death (CDCD) is an important way to solve the donor shortage problem,but if we can't effectively control warm ischemia time of CDCD donor,it's easy to cause grafts primary nonfunction,early grafts dysfunction and biliary complications.Nowadays,with the development of surgical techniques,the definition of warm ischemia continues has been continuously updated.The understanding on different definitions may lay the foundation for improving the survival rate of liver and kidney and effectively protect liver and kidney function after transplantation.This paper overviewed the significance of different definitions of warm ischemia and its effect on liver and renal function,which could provide a reference for further experimental study and clinical practice.